Alaska's 1st health care decision: To exchange or not to exchange?

Parnell administration deciding whether to build own online insurance marketplace, or let the feds do it

Alaska is already facing its first decision following Thursday’s landmark U.S. Supreme Court ruling upholding the Affordable Care Act that was challenged by Alaska and other states.

Health officials are now reviewing a consultant’s report to decide how — and whether — Alaska should develop a Health Insurance Exchange, as required by the federal act.

Alaska gained notoriety last year, and praise from the opponents of “Obamacare” when it rejected federal planning funds for the creation of an exchange intended as an electronic marketplace for purchasing the new insurance that will be available as part of the act.

“We did turn down the money, we were the first state — the only state — to not take the first planning money,” said Bill Streur, Commissioner of the Department of Health and Social Services.

“Several states have since joined us by returning the money,” he said.

A consultant working for the state has developed a report for the department on which it will likely base its decision on whether or not to proceed.

Streur said that while an insurance exchange must be developed, it doesn’t say that Alaska itself must do it.

“We have to decide whether we get involved with our own exchange, whether we get in a multi-state partnership or whether we let the feds do it,” he said.

Streur said he and his staff are spending the weekend reviewing the draft report, trying to get a recommendation to Parnell as soon as possible.

“We’re going to look at the recommendations (in the consultant’s plan), come up with our own to the governor, then we’ll proceed from there based on his advice to us,” Streur said.

Deciding how to proceed may also let Alaska move forward with one of the goals outlined by Parnell after Thursday’s ruling, making the federal government pay for costs associated with complying with the Affordable Care Act.

“I will work to shift back to the federal government those costs they are shifting to us,” he said.

Alaska has rejected several planning grants so far, including $1 million for the health information exchange planning, saying it feared it would come with burdensome strings attached.

Streur said one of the immediate decisions facing the administration, if it decides to go forward with the exchange, will be whether to go “hat in hand” to the federal government and accept the money it is offering.

Streur said Alaska has so far spent well under $500,000 of its own money, holding down costs by getting advice from other states, with Utah being particularly helpful.

“We’ve avoided a lot of expensive consulting expertise by looking to other states,” he said.

Streur said he hopes to have a decision by mid July, in time to meet the federal deadline of showing them a plan by Jan. 1 of 2013.

That deadline, however, may be pushed back, he said.

“There’s significant rumors that the feds are not going to be ready by January 1,” he said.